Healthcare Provider Details

I. General information

NPI: 1194650366
Provider Name (Legal Business Name): TYLER BAER NOEL AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8133 ELLIOTT RD STE 3
EASTON MD
21601-2945
US

IV. Provider business mailing address

650 RITCHIE HWY STE 104
SEVERNA PARK MD
21146-3910
US

V. Phone/Fax

Practice location:
  • Phone: 410-647-7795
  • Fax: 410-315-8823
Mailing address:
  • Phone: 410-647-7795
  • Fax: 410-315-8823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01769
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: